Our Summary

This research paper discusses corneal transplantation, which is the most common and successful type of tissue transplant. The cornea is the clear front layer of the eye. To ensure the safety and success of the transplant, the donor and the cornea have to go through a thorough screening process. This process helps to avoid the risk of passing on any diseases or contaminants from the donor to the recipient, and also makes sure that the cornea is of high quality and will function well after the transplant.

The screening process is divided into three main steps:

  1. Evaluating and choosing the donor before the cornea is removed, which is done by the retrieval team;

  2. Examining the cornea during the storage phase, which is done by technicians at the eye bank after the cornea has been taken from the donor;

  3. Checking the quality of the cornea in the operating room before the transplant, which is done by the surgeons.

While advancements have made the process safer and improved the results of corneal transplants, there is still an issue with lack of standardization between different centers during some parts of the process. This could potentially affect the quality and quantity of corneas that are available for transplant. The paper goes into detail about the screening process and the challenges associated with each stage.

FAQs

  1. What is the importance of donor screening in corneal transplantation?
  2. What are the three stages involved in the corneal transplant process?
  3. What are some of the limitations associated with each stage of the corneal transplant process?

Doctor’s Tip

A doctor might tell a patient undergoing a corneal transplant to follow all post-operative care instructions carefully, including taking prescribed medications, attending follow-up appointments, and avoiding activities that could put strain on the eye. It is important to communicate any changes in vision or discomfort to the doctor immediately to ensure the best possible outcome.

Suitable For

Patients who are typically recommended for corneal transplant include those with the following conditions:

  1. Corneal scarring or opacities that impair vision
  2. Corneal degenerations, such as keratoconus or Fuchs’ dystrophy
  3. Corneal infections or ulcers that do not respond to medication
  4. Corneal dystrophies, such as lattice dystrophy or granular dystrophy
  5. Corneal injuries or trauma that result in permanent damage
  6. Corneal swelling or edema that affects vision
  7. Corneal irregularities, such as astigmatism, that cannot be corrected with glasses or contact lenses

It is important for patients to undergo a thorough evaluation by an ophthalmologist to determine if they are suitable candidates for corneal transplant surgery. Additionally, the availability of donor corneas and the quality of the donor tissue are factors that may influence the decision to proceed with a corneal transplant.

Timeline

Before corneal transplant:

  1. Patient is diagnosed with a corneal condition that cannot be corrected with glasses, contact lenses, or medication.
  2. Patient undergoes a thorough eye examination to determine if a corneal transplant is necessary.
  3. Patient is placed on a waiting list for a suitable cornea donor.
  4. Donor evaluation and selection process is conducted by the retrieval team to ensure the safety and quality of the donor tissue.
  5. Donor tissue is analyzed and stored by eye bank technicians to maintain its optical and functional quality.

After corneal transplant:

  1. Patient undergoes corneal transplant surgery performed by ophthalmic surgeons.
  2. Surgeons conduct tissue quality checks in the operating room before transplantation to ensure the success of the procedure.
  3. Patient goes through a recovery period post-surgery, which includes regular follow-up appointments to monitor the healing process.
  4. Patient may experience some discomfort, blurry vision, and sensitivity to light during the initial stages of recovery.
  5. Over time, the transplanted cornea gradually heals and vision improves, leading to visual rehabilitation for the patient.

What to Ask Your Doctor

  1. What is the success rate of corneal transplants?
  2. What are the risks and potential complications associated with corneal transplant surgery?
  3. How long is the recovery process after a corneal transplant?
  4. How will I need to care for my eye after the surgery?
  5. What are the options for donor corneas and how are they screened for safety and suitability?
  6. How will the donor cornea be matched to my specific needs?
  7. What factors determine the overall success of a corneal transplant surgery?
  8. How long do donor corneas typically last and what is the likelihood of rejection?
  9. What are the alternatives to corneal transplant surgery if it is not successful?
  10. How many corneal transplants has the surgeon performed and what is their success rate?

Reference

Authors: Romano V, Passaro ML, Ruzza A, Parekh M, Airaldi M, Levis HJ, Ferrari S, Costagliola C, Semeraro F, Ponzin D. Journal: Surv Ophthalmol. 2024 May-Jun;69(3):465-482. doi: 10.1016/j.survophthal.2023.12.002. Epub 2024 Jan 8. PMID: 38199504